دورية أكاديمية

Predictors of CD4(+) T-cell counts of HIV type 1-infected persons after virologic failure of all 3 original antiretroviral drug classes.

التفاصيل البيبلوغرافية
العنوان: Predictors of CD4(+) T-cell counts of HIV type 1-infected persons after virologic failure of all 3 original antiretroviral drug classes.
المؤلفون: Pursuing Later Treatment Option II (PLATO II) Project Team of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE), Costagliola, Dominique, Ledergerber, Bruno, Torti, Carlo, van Sighem, Ard, Podzamczer, Daniel, Mocroft, Amanda, Dorrucci, Maria, Masquelier, Bernard, de Luca, Andrea, Jansen, Klaus, De Wit, Stephane, Obel, Niels, Fätkenheuer, Gerd, Touloumi, Giota, Mussini, Cristina, Castagna, Antonella, Stephan, Cristoph, García, Federico, Zangerle, Robert
المصدر: Journal of Infectious Diseases; Mar2013, Vol. 207 Issue 5, p759-767, 9p
مستخلص: Background: Low CD4(+) T-cell counts are the main factor leading to clinical progression in human immunodeficiency virus type 1 (HIV-1) infection. We aimed to investigate factors affecting CD4(+) T-cell counts after triple-class virological failure.Methods: We included individuals from the COHERE database who started antiretroviral therapy from 1998 onward and who experienced triple-class virological failure. CD4(+) T-cell counts obtained after triple-class virologic failure were analyzed using generalized estimating equations.Results: The analyses included 2424 individuals with a total of 23 922 CD4(+) T-cell count measurements. In adjusted models (excluding current viral load and year), CD4(+) T-cell counts were higher with regimens that included boosted protease inhibitors (increase, 22 cells/µL [95% confidence interval {CI}, 3.9-41]; P = .017) or drugs from the new classes (increase, 39 cells/µL [95% CI, 15-62]; P = .001), compared with nonnucleoside reverse-transcriptase inhibitor-based regimens. These associations disappeared when current viral load and/or calendar year were included. Compared with viral levels of <2.5 log(10) copies/mL, levels of 2.5-3.5, 3.5-4.5, 4.5-5.5, and >5.5 log(10) copies/mL were associated with CD4(+) T-cell count decreases of 51, 84, 137, and 186 cells/µL, respectively (P < .001).Conclusions: The approximately linear inverse relationship between log(10) viral load and CD4(+) T-cell count indicates that there are likely immunologic benefits from lowering viral load even by modest amounts that do not lead to undetectable viral loads. This is important for patients with low CD4(+) T-cell counts and few drug options. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
قاعدة البيانات: Complementary Index
الوصف
تدمد:00221899
DOI:10.1093/infdis/jis752